REWRITALIZE Your Recovery - Evaluation of a Creative Writing Group Intervention

Summary

Health institutes call for psychosocial interventions and recovery-oriented approaches as supplement to pharmacological treatment for mental health disorders. Participatory art interventions have been suggested to be promising in promoting recovery by stimulating connectedness, hope, renegotiation of identity, participatory meaning-making and empowerment. Moreover, cognitive literature studies suggest there might be potential benefits of engaging with literature in terms of improved cognition and social cognition. In spite of promising findings, the evidence base is still thin. We have developed REWRITALIZE (REWR), a manualised, recovery-oriented fifteen-session participatory creative writing group intervention, led by a professional author and attended by a mental health professional. The intervention comprises introduction to literary forms, spontaneous writing on those forms, sharing texts and engaging in reflective discussions about them. It is designed to provide a holding and non-stigmatising environment.

The aim of the present study is to evaluate REWR for persons with severe mental illness. This study is a randomised controlled clinical trial (RCT) with an embedded pilot RCT focusing on clinical and personal recovery.

This study is an investigator-initiated, randomised, two-arm, single-blinded, multi-center, waiting list trial. Participants (n=266) with severe mental illness (\>18 yrs.) will be recruited at six psychiatric centres in region Zealand and randomised to active (creative writing group + treatment as usual) or control (waiting list + treatment as usual) condition. Assessments will be collected pre- and post-intervention and six months after end of intervention. The primary outcome measure will be the questionnaire of the process of recovery administered at the end of the intervention. Secondary outcome measures comprise measures of recovery, self-efficacy and mentalising assessed at the end of the intervention and six months after the intervention ends. The post-intervention measures will be compared between active and control groups by means of independent sample t-tests. The pilot RCT will focus on a subset of participants (n=70) with schizophrenia spectrum disorders (18-35 yrs), evaluating exploratory outcome measures related perspective-taking, social cognition, cognitive function, psychosocial functioning, and symptom level.

Conditions

• Schizophreniform Disorders
• Bipolar Disorder
• Severe Depression
• Ptsd
• Personality Disorder, Borderline
• Psychosis

Interventions

OTHER

Rewritalize

REWR is conceptualised as a hybrid between an art group and a group therapy intervention. It is structured as a progressive participatory art group program led by a conductor-tandem: the primary conductor, a professional writer with extensive teaching experience, is supplemented by a co-conductor with clinical expertise who participates in the group activities together with the other participants. The conductor-tandem secure high artistic standards while also ensuring psychological safety. A close collaboration between the two is necessary and both participate in a 30-hour preparatory course and are supervised during the course of the intervention. The writing course consists in 15 sessions of 3 hours per session. At each session participants are introduced to literary texts that work as prompts for the writing exercises, which last 5-15 min. After each text is read out loud, the participants engage in a reflective discussion about the text.

OTHER

Standard mental health care

F-ACT is a community-based treatment model that provides multidisciplinary, flexible, and assertive outpatient treatment to patients with severe mental illness. OPUS is a nationally implemented 2-year-long early intervention for people with first-episode psychosis. OPUS is a multidisciplinary assertive community treatment model and offer psychoeducation, social skills training, relapse prevention and family involvement, including possibility for treatment participation in psychoeducational multifamily groups. In F-ACT and OPUS a primary staff member is in regular contact with the patient and responsible for coordinating the treatment elements. The treatment is individual and contingent upon patients' needs.

Sponsors & Collaborators

• Amager Hospital

  lead OTHER

Principal Investigators

• Lene F Eplov, Dr. · Mental Health Services Capital Region Denmark

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-02-12

Primary Completion

2026-10-31

Completion

2027-04-30

Countries

• Denmark

Study Locations